Hi sonas2013,
The Laya plan 'Company Care Plus' would be an ideal alternative to Health Plus Premium(Plan D).
I wouldn't see it as that much of a step down, overall it probably has actually a lot more to offer than Plan D - strange as it may seem.
You won't lose that much but will also gain quite a lot.
Since 2008, there have been a lot of changes regarding cover in the Blackrock Clinic and Mater Private for mid-range plans.
The Blackrock Clinic and Mater Private are now fully covering a wide range of surgery, on mid-range plans with a minimum of 45% hi-tech
hospital cover. These hospitals are not charging shortfall amounts for many types of surgery for the past 5 years.
Plans with Aviva, Glohealth and VHI show their shortfall in % rates and Laya Healthcare show their shortfall amount in euros.
All qualify for these waivers.
An example of the different types of surgery fully covered include cardiac, orthopaedic, many types of cancer surgery and other general surgery.
The Blackrock Clinic fully cover the majority of surgeries on mid-range plans.
When I queried what type of surgery would NOT be fully covered, the person actually found it hard to think of one and a
tonsillectomy( tonsils removal for an adult only, they fully cover a child's tonsillectomy) was the only one they could think of.
The relevant shortfall per night would be charged for this operation.
It was explained to me that the majority of surgeries are covered and very little is not covered with Blackrock Clinic.
This hospital also completed a full renovation in 2007, so all rooms in the hospital are single, private rooms with ensuite bathroom facilities.
There are no shared wards in Blackrock Clinic now. So in effect, a mid-range plan is more like a top-range plan such as Plan D - without
the cost.
Mater Private fully cover cardiac and orthopaedic surgery and a range of other types of surgery, some surgeries have a reduced
shortfall amount, it depends if the surgery is classed as a 'Fixed Price Procedure'.
Regarding your own situation and choosing an alternative to Health Plus Premium(Plan D), there are a few alternatives to consider;
OPTION 1; LAYA
1. Company Care Plus; adult price; 1201pa(1237)pa - good hospital cover + excellent day to day outpatient cover(75% refund) 1 euro excess.
www.hia.ie/ci/comparison/step3?72&198/
OPTION 2; LAYA
2. Total Health Select; adult price; 1405pa(1457)pa - same cover as Company Care Plus with the extra full cover for a private room in a
private hospital + same day to day outpatient cover( 75% refund) 1 euro excess.
www.hia.ie/ci/comparison/step3?72&322/
OPTION 3; AVIVA
3. Health Plan 09; adult price; 2413pa - this plan is identical to Health Plus Premium hospital cover + good outpatient cover (no excess).
www.hia.ie/ci/comparison/step3?72&332/
Company Care Plus is more than adequate cover for all your needs, including hi-tech cover as explained already and excellent day to day
outpatient cover, which amazingly is NOT included on Health Plus Premium plan, despite the high cost.
I included options 2 + 3 to show the full picture as to what alternatives are available at that level which may help other readers also.
As regards claiming for outpatient expenses gp, dental, consultants etc - you must keep all the relevant receipts and submit your claim every
year within 3 months after your renewal date.
Hope this explains the upto date position a bit clearer and makes choosing a little easier.
Regards, Snowyb